Implementation of Entrustable Professional Activities assessments in a Canadian obstetrics and gynecology residency program: a mixed methods study
DOI:
https://doi.org/10.36834/cmej.72567Abstract
Background: Since the implementation of competency-based medical education (CBME) across residency training programs in Canada, there has been limited research understanding how entrustable professional activity (EPA) assessments are used by faculty supervisors and residents.
Objective: This study examines how EPA assessments are used in an Obstetrics and Gynecology residency program and the impact of implementation on both groups.
Methods: A mixed methods study design was used. Part one involved the aggregation of descriptive data of EPA assessment completion for postgraduate year 1 and 2 residents from July 2019 to May 2020. Part two involved a thematic analysis of semi-structured interviews of residents and faculty.
Results: There was significant uptake of EPA assessments across community and teaching hospitals with widespread contribution of assessment data from faculty. However, both residents and faculty reported that the intended design of EPA assessments as low-stakes assessments to provide formative feedback is not how EPA assessments are experienced. Residents and faculty noted the increased level of administrative burden and related perceived stress amongst the resident group.
Conclusions: The implementation of EPA assessments is feasible across a variety of sites. However, previous measurement challenges remain. Neither residents nor faculty perceive the value of EPAs to improve feedback, despite their intended nature.
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References
McGaghie WC. Competency-based curriculum development in medical education. an introduction. Public Health Papers No. 68.
Englander R, Frank JR, Carraccio C, et al. Toward a shared language for competency-based medical education. Med Teach. 2017;39(6):582-587. https://doi.org/10.1080/0142159X.2017.1315066
Ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. 2007; 82: 542-547. https://doi.org/10.1097/ACM.0b013e31805559c7
Rekman J, Gofton W, Dudek N, Gofton T, Hamstra S. Enstrustability scales: outlining their usefulness for competency-based clinical assessment. Acad Med. 2016; 19(2): 186-190. https://doi.org/10.1097/ACM.0000000000001045
Yeates P, O’Neill P, Mann K, Eva K. Seeing the same thing differently: mechanisms that contribute to assessor differences in directly observed performance assessments. Adv Health Sci Educ Theory Pract. 2013;18: 325–341. 3. https://doi.org/10.1007/s10459-012-9372-1
Boet S, Pigford AE, Naik VN. Program director and resident perspectives of a competency based medical education anesthesia residency program in Canada: a needs assessment. Korean J Med Educ. 2016; 28(8):157-168. https://doi.org/10.3946/kjme.2016.20
Hall AK, Rich J, Dagnone JD, et al. It’s a Marathon, not a sprint: rapid evaluation of competency-based medical education program implementation. Acad Med. 2020;95(5):786-793. https://doi.org/10.1097/ACM.0000000000003040
Dujin CMA, Welink SL, Mandoki M, et al. Am I ready for it? Students’ perceptions of meaningful feedback on entrustable professional activities. Perspect Med Educ. 2017;6:256-264. https://doi.org/10.1007/s40037-017-0361-1
Ng S, Lingard L, Kennedy TJ. Qualitative research in medical education: methodologies and methods. In: Swanwick T, editor. Understanding medical education: evidence, theory and practice. Wiley-Blackwell. 2014. p. 371-384. https://doi.org/10.1002/9781118472361.ch26
Dudek N, Gofton W, Rekman J, McDougall A. Faculty and resident perspectives on using entrustment anchors for workplace based assessment. J Grad Med Educ. 2019; 11(3): 287-294. https://doi.org/10.4300/JGME-D-18-01003.1
Martin L, Sibbald M, Brandt Vegas D, Russell D, Govaerts M. The impact of entrustment assessments on feedback and learning: Trainee perspectives. Med Educ.2020; 54(4), 328-336. https://doi.org/10.1111/medu.14047
Crossley J, Johnson G, Booth J, Wade W. Good questions, good answers: Construct alignment improves the performance of workplace-based assessment scales. Med Educ. 2011; 45: 560–569. https://doi.org/10.1111/j.1365-2923.2010.03913.x
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